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Illinois rates for HCPCS 97155

Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes

Facilitymedian $195 · 10th–90th $19–$1950%20%40%10th$195Professionalmedian $21 · 10th–90th $18–$540%20%10th90th$21$20.0$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $194.98 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $85.11
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $22.91 / $24.55
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $229.09
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $36.31 / $36.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $32.36 / $52.48
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $44.67 / $102.33
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $478.63 / $676.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $40.74 / $64.57